Care Coordinator

3 weeks ago

Chester, United Kingdom Chester South PCN Full time

**Job Summary**

The Care Coordinator will liaise with practice clinical teams and the PCN management team to ensure patients receive timely and appropriate direction or appointments according to their healthcare need.

To provide coordination and navigation for people and their carers across health and care services

Support Safeguarding Leads in each practice with administration of child and adult relevant safeguarding procedures. Completing Social Services reports/arranging Social Service meetings. Identifying any Safeguarding metrics.

Support national screening programmes

Support immunisation programmes

Utilise GP Practice clinical systems (EMIS) and population health data to proactively identify and work with relevant cohorts of patients to deliver personalised care and deliver against health objectives under relevant contracts (e.g. PCN Service Specifications)

To engage with GP practices, local healthcare providers and key support service organisations who will assist in identified support and to create essential pathways for patients to access the appropriate services

The post holder will have regular contact with a wide range of clinical and managerial staff, administrative support staff and local health/social care service providers and charities.

You may be required to undertake a proportion of your contracted hours within times considered to be Enhanced Access / Access as practice need dictates.

**Chester South PCN Mission and Vision Statement**

**Our mission**: To work together for the benefit of our communities to provide high quality care

**Our vision**: To work collaboratively with a team of Healthcare providers and Partners to deliver a high level of integrated, seamless and responsive care. We will improve patient outcomes by ensuring patients are central to our care decision making

**Primary Responsibilities**

The following are the core responsibilities of the Care Coordinator. There may be on occasion, a requirement to carry out other tasks; this will be dependent upon factors such as workload and staffing levels.
- To provide coordination and navigation for people and their carers across health and care services
- Support national screening programmes
- Support immunisation programmes
- Support Safeguarding Leads in each practice with administration of relevant processes
- Participate in clinical governance activity and contribute to the improvement in quality of health outcomes through audit, risk management and Quality Improvement
- Alert other team members to concerns about risk, quality, and safety
- Participate in investigation of incidents and events as required
- Utilise GP Practice clinical systems (EMIS) and population health data to proactively identify and work with relevant cohorts of patients to deliver personalised care and deliver against health objectives under relevant contracts (e.g. PCN Service Specifications)
- To engage with GP practices, local healthcare providers and key support service organisations who will assist in identified support and to create essential pathways for patients to access the appropriate services
- To encourage patients to consider opportunities for physical and social activity, and to encourage and motivate people, using creative ways of addressing negative behaviours.
- Assist patients to access self-management education courses, peer support or interventions that support them to take more control of their health and wellbeing in relation to the PCN Service Specifications
- Develop and maintain a clear and up to date knowledge of the local services, patient pathways and availability to ensure effective and efficient utilisation of appropriate service provision by directing patients to these services as appropriate whilst promoting they make informed choices.
- Refer to PCN social prescribing link workers where a patient is identified as potentially benefitting from this service
- Support the coordination and delivery of Multi-Disciplinary Team meetings (MDTs)
- To report as required on activity and outcomes
- Assist in any project or defined quality improvement work as directed
- Collect data for audit purposes and use clinical audit to monitor quality in the service
- To attend conferences, meetings and training events as required
- Responsible for the accurate input and maintenance of patient records and confidential data onto relevant Practice IT systems, making amendments as necessary
- Support Quality and Outcome Frameworks and other DES/LES specifications
- To support individuals in a respectful and non-judgemental manner to recognise and change their current lifestyle and to identify how their way of lifestyle choices might affect their health and wellbeing
- Develop excellent working relationships and networks with all partners, wider service networks including the voluntary sector, adult and children’s social care, hospitals, community pharmacists and other members of the Network
- Ensure that Practice standards are met

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